Breast Reconstruction Options

Breast Implants/Tissue flap reconstruction


By Brandie Umar, Executive Director of ContentLast modified: December 01, 2011



Breast Reconstruction Options Defined

Following a mastectomy women have two options for breast reconstruction surgery. Surgeons can reconstruct breasts with breast implants or a flap of tissue and fat from another area of the body. The reconstruction method used will depend on the amount of tissue and fat available and the desired feel and appearance of the breasts after surgery.Surgery may either be performed immediately after a mastectomy in a combined procedure or in a separate operation later.



Breast Implant Reconstruction

Using breast implants to recreate the breasts often allows surgeons to perform reconstructive breast surgery at the same time as a mastectomy. This immediate reconstruction means only one surgery is necessary.

If the skin and tissue on the chest wall is too tight to cover breast implants, surgeons will insert a tissue expander under the skin and will gradually stretch the tissue. Once the skin has been stretched and there is enough to cover the implant, the breast reconstruction surgery will be performed using either a silicone or saline breast implant to recreate the contours of a natural breast.

There are many benefits to undergoing breast reconstruction surgery in a separate procedure to a mastectomy. If any additional cancer treatments are required, such as radiation therapy, it is possible for patients to undergo treatment before the reconstructive surgery.

Tissue Flap Reconstruction

Tissue flap breast reconstruction is performed using a flap of tissue, fat and muscle from another area of the body to reconstruct the breast.

The most commonly used area to take tissue from for reconstructive purposes is the lower stomach. This procedure is known as a TRAM (transverse rectus abdominis myocutaneous)procedure.


A TRAM procedure can be performed in two ways: pedicle flap surgery or free flap surgery.

Pedicle flap
: The flap of tissue, skin and muscle is left conected to the blood supply of the stomach and is passed underneath the skin to the breast area. This method of breast reconstruction is commonly used as the surgery is easier and quicker to perform than microsurgery reconstruction. If maintaining abdominal muscle strength is important this procedure may not be recommended as the muscle in the stomach will be weakened by this procedure.

Free flap:
A flap of tissue, skin and muscle is removed from the stomach and is reconnected to the blood supply in the chest. This procedure requires an artery and a vein to be removed from the abdominal area to create a blood supply in the reconstructed breast.Free flap surgery is used less frequently as it is a complex microsurgery procedure. 

Nipple And Areola Reconstruction

It may be possible for the nipple and areola to remain attached to the breast tissue during a mastectomy in a procedure known as nipple-sparing mastectomy. In this procedure only the damaged breast tissue is removed. This type of surgery is not as commonly used as a traditional mastectomy as there is a risk of cancer cells remaining in the nipple post-surgery.

It is likely the nipple and the areola will be removed from the breast during a mastectomy procedure. Surgeons will then create a new nipple after breast reconstruction surgery. To reconstruct a nipple the surgeon will remove skin from another area of the body and reshape it on the breast. Tattoos are used to create the appearance of an areola around the nipple.













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